Eco-WarriorsApplication Form

Thank you for your interest in joining the Eco-Warriors project. Please take your time to complete this application thoroughly to give us the opportunity to know you better. Add lines where necessary.

Personal Information

First Name: Last Name: Gender: Date of Birth:Nationality:Address:Home Phone: Mobile Phone: Email Address: Work Phone:

Education

Institution: Degree:Major: (Expected) Graduation year:

Volunteering and/or campaigning experience

Do you have any previous experience in volunteering activities, working with civil society organizations or being involved in any campaigns? If yes, please share your experience in detail. (1 page max)

Work Experience

Company/ Organization/Etc.: Position and responsibilities:Company/ Organization/Etc.: Position and responsibilities:

Language skills (list languages and proficiency)

Hobbies, Skills & Interests

Why do you want to join Eco-Warriors? (1/2 page max)

Why do you think you are a good candidate for this fellowship? (1 page max)

Where do you see yourself in five years? What are your plans for the future? (1/2 page max)

What environmental problems are you concerned with/ interested to work on? (1page max)

What do you believe in? What are your values? (1/2 page max)

Date:

Thank you! Please return your application to admin@indyact.org before October 30, 2011.